Brian Maiz, Medicare Insurance Agent

Answer: It sounds counterintuitive, but sometimes the most expensive plan on paper is actually the smartest choice. When people shop Part D, they naturally gravitate toward the lowest monthly premium. That's understandable but premium is only one piece of the puzzle. The number that actually matters is your total annual cost: premium plus deductible plus what you'll pay at the pharmacy for your specific medications. If your medication is covered at a lower cost on a higher premium plan, it could still save you money in the long run. That's why it's important to sit down with a professional to go over all options and true out-of-pocket expenses.

Answer: Creditable coverage simply means you have existing coverage that's at least as good as Medicare's standard benefits. It's your proof that you weren't without decent coverage during a period when you could have enrolled.

Medicare has enrollment windows, and if you miss them without a valid reason, you can face permanent late enrollment penalties and proof of credible coverage will protect you from them.

The most common situation is still working at 65 with coverage through your employer or your spouse's employer. If that coverage is creditable, you can delay Medicare enrollment without penalty. Once that ends though, you typically have just 63 days to enroll before penalties kick in.

Answer: There is a ton of free resources available on Medicare.gov and that working with an agent such as myself, is absolutely free to you. I'm not a call center with a quota but a real member of your community. I work for you and have no incentive to steer you in any direction other than to find out what works best for you and your specific situation. Bonus is that I want to keep you as a client and friend for life!

Answer: With an HMO, it's tough but there are exceptions. HMOs are built around a network. Unlike a PPO, they generally don't cover out-of-network care except in a true emergency, or urgent care when you're away from home. Outside of those, if you see a cardiologist who isn't in your plan's network, you're likely paying the full bill yourself.

Most HMO's require you to get a referral from your primary care doctor before seeing any specialist, including a cardiologist. Skipping that can create coverage problems even when the doctor is in-network.

If you're already working with a cardiologist you trust, this is really important to sort out before looking at plan. We can sit down and confirm your doctor's network status, and make sure the referral process is all squared away and that you're not hit with any unexpected expenses.

Answer: The donut hole is officially gone as of 2025, and it's one of the biggest wins for Medicare beneficiaries in a long time. Here's what changed. There's now a $2,000 annual cap on what you'll ever pay out-of-pocket for covered drugs. Once you hit it, your plan picks up the rest for the year.

If you're on expensive brand-name medications, this is a huge deal and if you're still worried about getting hit with that bill all at once, there's even a new option to spread your costs into monthly payments.

The one thing that hasn't changed though is that the right Part D plan still matters and

that's where I come in to make sure we get all your prescriptions covered at the lowest amount possible.

Answer: This happens more than it should, and it's one of the most frustrating experiences in Medicare. Doctors and hospitals can leave a plan's network mid-year, and plans update their provider directories more often than most people realize. There always seems to be a battle between providers and insurers and people unfortunately get caught in the crossfire.

I wish that wasn't the case and had a better answer for you. At least with a professional by your side, I'll keep you up to date with any network changes as soon as I find out as to prevent you from being caught off guard and without options.

Answer: Every Part D plan has a drug list called a formulary. Brand-name drugs are typically placed in higher tiers which usually means higher costs. You want to find a plan where your specific medication lands on the lowest tier possible. Also, plans can vary widely in their prescription costs. For example, a drug may be $80 a month on one plan and $300 on another. This is why it is especially important to speak with a professional to figure out your true monthly out-of-pocket costs.

You could also use Medicare's Plan Finder at medicare.gov where you enter your exact medication and dosage to compare plans offered in your area. It's one of the most useful tools Medicare offers however I don't recommend that you do it alone as it can get confusing. This is where an agent like myself can walk you through all the scenarios and make sure you are getting the best plan.

Answer: That's a great question. Medicare Advantage plans vary by service area and zip code. Also, not all carriers are available in all states so I really can't answer that question fully without having more information. It will really depend on where you are moving to.

However, the great news is that I'm licensed in multiple states and can help make the transition as smooth as possible without having to switch agents. I'll provide you with exact changes if any once we know your new zip code.

Answer: Probably not and here's why.

Medigap was a smart choice for someone who travels. Unlike Medicare Advantage, it works with any doctor who accepts Medicare, anywhere in the country. That kind of freedom matters when you're on the road.

However, what your feeling now is probably premium creep. Medigap premiums rise with age, and over time they can start to sting. But here's the good news: the same coverage (say, Plan G) is offered by multiple carriers at very different price points. You may be able to get identical benefits for significantly less just by switching carriers.

The right move is a quick review of your current plan and what you're paying, what you're getting, and whether your travel habits have changed enough to reconsider your options. That's the only real way to tell for sure and that's what I'm here for.

Answer: This is one of the most consequential decisions you'll make as a Medicare beneficiary and most people don't have enough information to make it confidently as they are both significantly different.

Original Medicare vs. Medicare Advantage: Which is better?

Original Medicare gives you freedom and access to any provider who accepts Medicare, no network restrictions, no referrals, no prior authorizations. Out-of-pocket costs can be managed with a Medigap supplement plan however those usually have a monthly premium. Without one, you could be responsible for significant costs, as regular Medicare only covers 80% with no max out-of-pocket. It also does not cover dental, vision or hearing.

Medicare Advantage plans are built different and bundle coverage through a private insurer often at a $0 premium with added dental, vision, hearing, and other benefits. Plan benefits can vary greatly from one carrier to another. Some carriers also offer plans specifically built for those with chronic conditions such as diabetes or heart disease. The trade-off: networks, prior authorizations, and copays at the point of care.

Neither is universally better. The right answer depends on your doctors, prescriptions, health history, lifestyle, and financial situation.

As an independent broker, I help clients just like you work through this decision based on what actually fits your life and my consultations are always free.

Answer: The short answer is that it costs you nothing but what you gain is everything. My services are 100% free and while some parts of Medicare may seem straightforward, other parts not so much especially around penalties, specific deadlines, formularies, chronic conditions, financial help etc. Plus, having the wrong plan could cost you real out of pocket pain.

The other aspect to it is that a plan which works perfectly for your neighbor or even a spouse may be completely wrong for you. Your lifestyle, doctors, your prescriptions, your budget are all unique and your coverage should reflect that.

As an independent broker, I'm not tied to any single carrier. I take the time to understand your specific situation and shop across multiple plans to find the right fit for you!!

I'm not here just for enrollment. When a billing issue comes up, when your needs change, when it's time to review your coverage each year, I'm a real person you can call or meet in person and always have your best interest at heart.